NSG 555 Exam 1 V3 | NSG 555 Nurse Practitioners
in Primary Care I | Wilkes University | 2026 Q&A
with Rationale (Wilkes NSG555 Exam 1 2026)
1. A 55-year-old male presents for a routine physical. His blood pressure today is 142/92
mmHg. According to the ACC/AHA 2017 guidelines, how should this be classified?
A. Stage 2 Hypertension
B. Stage 1 Hypertension
C. Elevated Blood Pressure
D. Hypertensive Urgency
Correct Answer: A
Explanation: According to the 2017 ACC/AHA guidelines, Stage 2 Hypertension is defined
as a systolic blood pressure of at least 140 mmHg or a diastolic blood pressure of at least
90 mmHg. The patient’s reading of 142/92 mmHg meets both criteria for Stage 2. Accurate
classification is essential for determining the appropriate pharmacological intervention
and follow-up schedule in primary care.
2. Which of the following findings on a physical examination is most characteristic of bacterial
conjunctivitis?
A. Thick, purulent discharge with ‘matted’ eyelids upon awakening
B. Marked pruritus and stringy discharge
,C. Significant watery discharge and preauricular lymphadenopathy
D. Cobblestone papillae on the upper tarsal conjunctiva
Correct Answer: A
Explanation: Bacterial conjunctivitis is typically characterized by a thick, purulent
discharge that causes the eyelids to stick together or ‘mat’ overnight. In contrast, viral
conjunctivitis usually presents with watery discharge and lymphadenopathy, while allergic
conjunctivitis is associated with intense itching. Proper differentiation of these symptoms
guides the clinician in deciding whether to prescribe topical antibiotics.
3. According to the USPSTF, at what age should routine screening for colorectal cancer begin
for average-risk adults?
A. 40 years old
B. 55 years old
C. 50 years old
D. 45 years old
Correct Answer: D
Explanation: The USPSTF updated its guidelines in 2021 to recommend that colorectal
cancer screening begin at age 45 for adults at average risk. This change was implemented
due to the rising incidence of early-onset colorectal cancer in younger populations.
Screening can be performed using stool-based tests or direct visualization methods like
colonoscopy.
,4. A patient presents with a ‘curtain-like’ shadow over their vision and flashes of light
(photopsia). Which condition should the nurse practitioner suspect?
A. Acute Angle-Closure Glaucoma
B. Cataracts
C. Retinal Detachment
D. Macular Degeneration
Correct Answer: C
Explanation: The classic presentation of retinal detachment includes the sudden
appearance of floaters, flashes of light, and a sensation of a shadow or curtain descending
across the visual field. This is a medical emergency that requires immediate referral to an
ophthalmologist to prevent permanent vision loss. Unlike glaucoma, this condition is
typically painless but highly vision-threatening.
5. Which of the following is considered the first-line treatment for an adult with
uncomplicated acute bacterial rhinosinusitis?
A. Azithromycin
B. Ceftriaxone
C. Levofloxacin
D. Amoxicillin-clavulanate (Augmentin)
Correct Answer: D
, Explanation: Amoxicillin-clavulanate is the recommended first-line antibiotic for acute
bacterial rhinosinusitis in adults due to the prevalence of Beta-lactamase producing
organisms. Macrolides like azithromycin are no longer recommended as first-line therapy
due to high rates of resistance among Streptococcus pneumoniae. The treatment duration
is typically 5 to 7 days for uncomplicated cases in adults.
6. In the management of COPD, which tool is primarily used to assess the severity of airflow
limitation?
A. Peak Flow Meter
B. Chest X-ray
C. Spirometry (FEV1/FVC ratio)
D. Pulse Oximetry
Correct Answer: C
Explanation: Spirometry is the gold standard for diagnosing and assessing the severity of
COPD, specifically looking for a post-bronchodilator FEV1/FVC ratio of less than 0.70. This
objective measurement confirms the presence of persistent airflow limitation which is a
hallmark of the disease. While other tests like chest X-rays may be used to rule out
comorbidities, they cannot diagnose COPD.
7. A 22-year-old female presents with a sore throat, fever, and cervical lymphadenopathy. A
Rapid Strep Test is negative. What is the most appropriate next step?
A. Prescribe Penicillin V and monitor for improvement
in Primary Care I | Wilkes University | 2026 Q&A
with Rationale (Wilkes NSG555 Exam 1 2026)
1. A 55-year-old male presents for a routine physical. His blood pressure today is 142/92
mmHg. According to the ACC/AHA 2017 guidelines, how should this be classified?
A. Stage 2 Hypertension
B. Stage 1 Hypertension
C. Elevated Blood Pressure
D. Hypertensive Urgency
Correct Answer: A
Explanation: According to the 2017 ACC/AHA guidelines, Stage 2 Hypertension is defined
as a systolic blood pressure of at least 140 mmHg or a diastolic blood pressure of at least
90 mmHg. The patient’s reading of 142/92 mmHg meets both criteria for Stage 2. Accurate
classification is essential for determining the appropriate pharmacological intervention
and follow-up schedule in primary care.
2. Which of the following findings on a physical examination is most characteristic of bacterial
conjunctivitis?
A. Thick, purulent discharge with ‘matted’ eyelids upon awakening
B. Marked pruritus and stringy discharge
,C. Significant watery discharge and preauricular lymphadenopathy
D. Cobblestone papillae on the upper tarsal conjunctiva
Correct Answer: A
Explanation: Bacterial conjunctivitis is typically characterized by a thick, purulent
discharge that causes the eyelids to stick together or ‘mat’ overnight. In contrast, viral
conjunctivitis usually presents with watery discharge and lymphadenopathy, while allergic
conjunctivitis is associated with intense itching. Proper differentiation of these symptoms
guides the clinician in deciding whether to prescribe topical antibiotics.
3. According to the USPSTF, at what age should routine screening for colorectal cancer begin
for average-risk adults?
A. 40 years old
B. 55 years old
C. 50 years old
D. 45 years old
Correct Answer: D
Explanation: The USPSTF updated its guidelines in 2021 to recommend that colorectal
cancer screening begin at age 45 for adults at average risk. This change was implemented
due to the rising incidence of early-onset colorectal cancer in younger populations.
Screening can be performed using stool-based tests or direct visualization methods like
colonoscopy.
,4. A patient presents with a ‘curtain-like’ shadow over their vision and flashes of light
(photopsia). Which condition should the nurse practitioner suspect?
A. Acute Angle-Closure Glaucoma
B. Cataracts
C. Retinal Detachment
D. Macular Degeneration
Correct Answer: C
Explanation: The classic presentation of retinal detachment includes the sudden
appearance of floaters, flashes of light, and a sensation of a shadow or curtain descending
across the visual field. This is a medical emergency that requires immediate referral to an
ophthalmologist to prevent permanent vision loss. Unlike glaucoma, this condition is
typically painless but highly vision-threatening.
5. Which of the following is considered the first-line treatment for an adult with
uncomplicated acute bacterial rhinosinusitis?
A. Azithromycin
B. Ceftriaxone
C. Levofloxacin
D. Amoxicillin-clavulanate (Augmentin)
Correct Answer: D
, Explanation: Amoxicillin-clavulanate is the recommended first-line antibiotic for acute
bacterial rhinosinusitis in adults due to the prevalence of Beta-lactamase producing
organisms. Macrolides like azithromycin are no longer recommended as first-line therapy
due to high rates of resistance among Streptococcus pneumoniae. The treatment duration
is typically 5 to 7 days for uncomplicated cases in adults.
6. In the management of COPD, which tool is primarily used to assess the severity of airflow
limitation?
A. Peak Flow Meter
B. Chest X-ray
C. Spirometry (FEV1/FVC ratio)
D. Pulse Oximetry
Correct Answer: C
Explanation: Spirometry is the gold standard for diagnosing and assessing the severity of
COPD, specifically looking for a post-bronchodilator FEV1/FVC ratio of less than 0.70. This
objective measurement confirms the presence of persistent airflow limitation which is a
hallmark of the disease. While other tests like chest X-rays may be used to rule out
comorbidities, they cannot diagnose COPD.
7. A 22-year-old female presents with a sore throat, fever, and cervical lymphadenopathy. A
Rapid Strep Test is negative. What is the most appropriate next step?
A. Prescribe Penicillin V and monitor for improvement
